浙江台州地区已婚妇女早期自然流产的相关危险因素分析

Analysis on related risk factors of early spontaneous abortion among married women in Taizhou

目的了解浙江省台州地区自然流产的流行病学特征,探讨导致早期自然流产的危险因素。方法选取浙江省台州恩泽医疗中心下属四家医院及台州市立医院早期自然流产的患者340例,选择同一时期在台州恩泽医疗中心进行健康体检的非自然流产者340例作为对照组。设计统一流行病学问卷,对基本信息、个人史、不良环境暴露情况、不良生活习惯进行调查,采用单因素和多因素logistic回归分析对危险因素进行筛查。结果单因素logistic回归分析结果提示：初次性生活年龄、婚外性伴侣数、孕次、初孕年龄、产次、产孕间隔、不良环境暴露、生殖道感染、精神压力、家族史、夜间工作、职业、劳动强度、孕前被动吸烟、既往流产史与自然流产有统计学意义（P〈0.05）。多因素logistic回归分析结果提示：初孕年龄≤20岁、精神压力大、婚外性伴侣数≥2、家族史、产孕间隔≤1年、孕次〉3、解脲支原体感染、既往有自然流产史、夜间工作、劳动强度大、孕前被动吸烟与自然流产发生相关,OR值（95%CI）分别为2.065（2.013-2.329）,11.712（4.596-29.843）,2.436（2.270-2.705）,2.110（2.018-2.681）,2.192（2.060-2.621）,10.085（2.251-45.189）,21.866（2.430-196.729）,2.500（1.492-4.188）,16.033（9.593-26.798）,2.772（1.057-2.163）,8.780（2.699-28.564）。结论浙江省台州地区自然流产防治重点人群包括初孕年龄≤20岁、精神压力大、婚外性伴侣数≥2、有家族史、产孕间隔≤1年、孕次〉3、解脲支原体感染、既往有自然流产史、夜间工作、劳动强度大、孕前有被动吸烟者。

Objective To discuss the risk factors related to early spontaneous miscarriage among married women in Taizhou. Methods A questionnaire survey was conducted among 340 married women who had a history of early spontaneous abortion as well as 340 women who experienced normal pregnancy from four hos pitals affiliated to Taizhou Enze Medical Center and Taizhou Municipal Hospital in Zhejiang province. Risk factors were analyzed by single and multiple factor logistic regression analysis methods. Results Single factor analysis showed that statistical significances were found in factors as initial sex age, numbers of extramarital sex partners and gravidity, primigravid age, para, pregnancy interval, adverse environmental exposure, geni tal tract infection, stress, family history, nightshirt work, occupation, labor intensity, passive smoking before pregnancy, history of abortion and spontaneous miscarriage （P〈0.05）. Meanwhile, multivariate analysis re vealed that the following factors were significantly associated with early spontaneous abortion as being preg nant at the age of 20 and younger, highly stressed out, having at least 2 extramarital sex partners and family history, pregnancy interval of less than a year, multigravidity, ureaplasma urealyticum infection, history of spontaneous abortion, nightshirt work, high labor intensity and passive smoking before pregnancy with the OR values （95% confidence interval）of 2.065 （2.013-2.329）, 11.712 （4.596-29.843）, 2.436 （2.270- 2.705）, 2.110 （2.018-2.681）, 2.192 （2.060-2.621）, 10.085 （2.251 45.189）, 21.866 （2.430-196.729）, 2.500 （1.492-4.188）, 16.033 （9.593-26.798）, 2.772 （1.057 2.163）, 8.780 （2.699 28.564）. Conclusions There are several factors closely associated with the early spontaneous miscarriage of married women in Taizhou, therefore, a comprehensive intervention is desired to prevent those abortions, especially among high risk women.